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Individual

POORNI MANCHUREKHA MANOHAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2201 INWOOD RD 3RD FLOOR NC3 500, DALLAS, TX 75390-4405
(214) 645-2615
Mailing address
PO BOX 845347, DALLAS, TX 75284-7280

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301102776
MI
207RH0003X
Hematology & Oncology Physician
MD60877995
WA
207RH0003X
Hematology & Oncology Physician
U4258
TX
207RX0202X
Medical Oncology Physician
Primary
U4258
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1912343807
WA
Enumeration date
05/17/2013
Last updated
04/02/2024
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